National Provider Identifier [NPI]: |
1285631564 |
Last Name Of The Provider |
WAITZMAN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
263 FARMINGTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FARMINGTON |
Zip Code Of The Provider |
060300001 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
1011 |
Number Of Medicare Beneficiaries |
282 |
Total Submitted Charge Amount |
180375 |
Total Medicare Allowed Amount |
82721.21 |
Total Medicare Payment Amount |
60711.21 |
Total Medicare Standardized Payment Amount |
58153.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
1011 |
Number Of Medicare Beneficiaries With Medical Services |
282 |
Total Medical Submitted Charge Amount |
180375 |
Total Medical Medicare Allowed Amount |
82721.21 |
Total Medical Medicare Payment Amount |
60711.21 |
Total Medical Medicare Standardized Payment Amount |
58153.93 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
119 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
113 |
Number Of Non Hispanic White Beneficiaries |
221 |
Number Of Black or African American Beneficiaries |
21 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
158 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.334 |